Claire, I was wondering if you would be interested in writing a guest post for SEDs on this topic as you have lived experience & expertise and thus I’m sure can do deeper justice to the issue than Tetyana, A., Gina or I who can only appreciate in the abstract the complexity and difficulties that having diabetes brings to having an ED. And I know you’re a good writer.

Claire – I agree with Saren, I think you would do a much better job of writing about this important topic than any of us currently contributing to the blog. If that doesn’t sound good for you right now, feel free to ask others who you think would do a good job/have experience with diabetes and eating disorders. You can send me an email at tetyana[@]scienceofeds[.]org to discuss.

I’m not in recovery (yet) but I just really wanted to get a better understanding of something. So here’s my story: I have been restricting my calories for 2 years now. I didn’t realize I had a problem until a year into falling into this disorder. And it was too late.. I started having chest pains, blacking out, my skin was orange, cold all the time (I would wear a sweatshirt in 80+f degree weather), etc. and I was scared. So I attempted self-recovery while still staying under 1,000 calories. My self-recovery only lasted 2 or 3 months and gained 5lbs. Now I’ve gained even more weight (about 5lbs more) and I can’t loose weight even with eating 300-580 calories a day. My BMI is now 15.2 My skin is no longer orange, I’m not nearly as sensitive to cold as I use to be, my hair looks (mostly) heathy again, skin isn’t so dry it bleeds, and I don’t black out anymore. So my question is, how is it possible that I feel so much better (physically) with eating so little and not losing weight? I’m not asking for tips or anything of course, I’m just really confused and curious.

At your extremely low intake, your metabolism is probably severely suppressed so a little can go a long way–although I suspect most of the weight you’ve gained is just water retention. Please don’t mistake the minor improvements you’ve seen for being ‘healthy.’ You’re still severely underweight and your heart and other organs are likely dangerously weakened. I would urge you to seek help to gain weight to a sustainable level and repair your body fully.

I wondered if you could post some research to do with non-purging bulimia, particularly bingeing/starving. I know it’s relatively uncommon, but if you cam across anything in your studies that would be super helpful! Thank you x

Yup! Great idea. There was a prevalence study that showed it is not really as uncommon as we might think. I think it was as high as 25%. Can’t recall what study now, though. I will add it to the list, thanks.

If there’s anything specific you want to see about the topic, let me know.

Is there anything specific? What would you like me to post about, because it is a huge area.

The reason I haven’t done anything on BED is really just because I don’t find myself reading those papers or being that interested in the research, so I don’t feel like I have enough background on it. It is not because I don’t think it is an eating disorder (it is!) or that it is any less important (it isn’t!), it is mostly that I find myself gravitating toward research on restricting and purging.

That said, I can do posts on it if people are interested in reading about. I will also ask Liz because I have a feeling she has more knowledge on that.

Pre-morbid BMI, weight restoration, and amenorrhoea in relation to set-point theory? I know that DSM-5 is removing the amenorrhoea criteria from the AN diagnosis, but I’d like to know more about why it occurs at different BMIs for different people (aside from the fact that BMI isn’t a great measure of health), and how post-recovery BMIs compare to pre-morbid BMIs…I was intensely annoyed at finding that I had to reach a BMI of 20 (rather than 18.5 as was often quoted at me) to get my periods back!

Dear Tetyana, Great blog! Recently Duclos 2013 and her colleagues tested Sodersten and Bergh’s theory against my adapted-to-flee-famine hypothesis of AN. Their evidence supported my Guisinger, 2003 article. Understanding that the powerful urges of anorexia nervosa made sense when starving hunter gatherers needed to travel to find food helps AN patients resist them.Anorexia nervosa sufferers need a compelling narrative to help them defy the anorexic voice that tells them not to eat and to run. Thank you, Shan Guisinger

Hi Shan,
Thank you so much for your comment. I actually have your Guisinger et al. article on my computer but have yet to read it; I will download Duclos et al. paper. What do you mean “a compelling narrative to help the defy the anorexic voice”? Defy or understand? The evolutionary side of things is definitely interesting to think about, but as you know, difficult (if not impossible) to test experimentally.
Tetyana

Great work here! I was wondering if you could research and post some info on PANDAS/PANS and it’s relationship to eating disorders. I know of several cases of PANDAS morphing into eating disorders. Thanks!

I would love to see if any clinical research has been done on the effect of EDs and orthopedic injuries. I am almost recovered from an ED myself and used to be an over exerciser, which I am not anymore. However, I am 31 and have had many orthopedic issues, particularly with my foot. I always wonder if it’s because I didn’t treat my body right, nutritionally, for half my life. What role does nutrition have on orthopedic issues, particulary when it comes to tendonitis/tendonosis, arthritis, etc. The effects on bones has been studied and known.

Hi! Do you have/could you find/could you cover research regarding gender nonconforming women and EDs? Especially any that aren’t just comparing rates with other women! Some friends and I have been striking out finding much.

I mean people who somewhat regularly binge and purge, yet it hasn’t actually transformed into a full-blown disorder for these people (i.e., they do these behaviours “casually”, and it’s only disordered eating, rather than actual bulimia).

I have often had a problem eating when I’ve felt anxious and this would seem a fairly common symptom is what I guess would be referred to an a normally-anxious population – it seems to be generally accepted sympathetically that when “normal” people go through a stressful time, their appetite may decrease and they might lose weight etc. I’ve previously been diagnosed with an eating disorder but I still have always had periods of stress-induced lack of appetite and weight loss. Usually the triggers for the stress resolve and things pick up, appetite resolves, weight stabilises but on occasions the stress does not let up and on those occasions eating-disorder mode kicks in with unrelenting anxiety. Is is possible to have or have-had an eating disorder but to experience “normal” appetite/stress reactions sometimes? Has any research been done on this? I feel as if I am treated sometimes as if I’m somehow expected to be immune to stress in a way that non-eating-disorders people are not and that the assumption that people leap to is that I would come up with any excuse not to eat even when they admit that they would probably find the same stressful situations difficult to cope with and may find it hard to eat under the same stressful circumstances.

I was wondering whether you guys could address the whole “extreme hunger” thing? I know it’s a concept that the YourEatopia/Minniemaud relies heavily on, but lately the “anti-MM” faction of tumblr has been insisting that it’s all pseudoscience and that there’s absolutely no scientific evidence to support the idea that extreme hunger is real. Would you agree with this? Thanks!

Hey M,
I am not entirely familiar with the evidence Gwyn points to for extreme hunger (outside I guess of the MSS, which I am not nearly as familiar with as she is). I can look into it, but I am not sure if I’ll find enough to comment on it that’s more than just speculation. I have a lot of hunches/thoughts on this (i.e., hard to study this if, for example, people with AN do not admit to experiencing hunger, which is common), but I’d need to read the evidence Gwyn puts forth and what people are defining as “extreme hunger.”
Cheers.

As far as “tribal knowledge” goes on the ED forums, there’s a general census among members that if a person is “wired” to get an ED, they’re inevitably going to get one. When I brought up the idea that “triggers” are needed in order to set off an ED, and that people who are indeed “wired” to get one might escape an ED, if they were fortunate enough not to be exposed to the proper triggers, the overwhelming response was that it’s simply impossible to avoid triggers these days, because of the nature of modern society. My sense is that at this point in time, it would be impossible to deny or confirm this hypothesis (that EDs are inevitable in some individuals…and conversely that others are protected, no matter their exposure to triggers) but it’s an interesting concept none the less, and one that currently receives a lot of play among the tribe.

I’m so glad I found this website, it is intelligent and informative and it has really helped me to understand eating disorders from a different perspective.
One thing I’m curious about is the psychological after-effects of eating disorders. There is a lot of discussion about how PTSD/trauma can lead to disordered eating, but can having an ED cause PTSD? my case, I’ve been “recovered” for four years, and not until recently, due to various triggers, I started having nightmares and persistent flashbacks of those experiences. It’s very vivid, I feel in a way I’m re-experiencing what happened before, it’s like I never “recovered”, because the thoughts and bodily feelings are exactly the same. In fact it has become so intense and intolerable that I’ve relapsed somewhat. Is being in an emaciated state for several years considered a form of trauma? Is being stuck in the B/P cycle, and living through the constant shame of it a form of trauma? I can’t find any research on this subject, and I wonder how other people deal with this sort of thing after recovery?

I am interested in any research/articles on the relationship between anorexia, migraines and serotonin. I have suffered from migraines for about 20 years, and an eating disorder for almost as long (although it wasn’t bad until the last few years). I have tried treatment after treatment to alleviate the migraines, but nothing seems to work. I am hoping that if I can restore my weight, I will see a decrease in migraines. I’m trying to use that hope as motivation, as it’s hard to change disordered eating habits that are 20 years in the making.

Hi.. how about high-functioning anorexia — perhaps an exploration of the factors that contribute to being high-functioning despite being at a low BMI (about 15-16). Does the body also adjust to being at a lower weight (in ‘chronic’ cases)?